Use water sparingly! Water has to be carried in from the spring, so while there is unlimited fresh water, it takes a lot of work to get into the clinic. So the water is placed in small buckets in the sink, and we wash our hands in it throughout the day. Then there is a wastewater bucket, where we throw dirty water, or spit out toothpaste…etc. I like the way it makes me use much less water. I take a lot less for granted here, and there is something refreshing about that. Maybe because it brings me back to the basics, the simple way of life that is less busy, less encumbered…less of everything.
Staff “kitchen” with the ever-flowing coffee pot, hot plate, microwave, bucket sink (and then the other normal kitchen things).
The clinic rooms:
The patient exam room
The waiting and check in room
The day was quite busy, with patients with a long chronic illness list, who are somewhat complicated medically, and it’s further complicated because I don’t know them at all, and the records are hard to navigate. Plus, a lot of the time we don’t have their complete records, and that takes a long time to request sometimes. From this trip I have learned that I must fax the admission paperwork back to the Village Health Aids, so they know what has been done for their patients, otherwise we have no idea what was done, and what we need to focus on in our follow up visits.
I had a lot of patients with heart disease, high cholesterol, high blood pressure and risk factors for more heart attacks, and while I was discussing diet with them, it became apparent that there is very little selection in the two stores in town, and that it is very difficult to get any produce. It is also outrageously expensive. So I decided to take a trip to the store to figure out exactly what I can tell my patients to eat, and what they should avoid.
The store clerk was very helpful, giving me information on how things work. And if I thought prices were high in Nome…these are shocking!!! The price of a gallon of milk works out to $14.75. One quart carton of long shelf life milk costs $3.35 x 4 = $13.40 plus tax ~$14.75!!!!
ubiquitous modern junk food. Uggghhh… Society destruction, round 2.
The other difficult thing is the selection. There are mostly processed non-perishable foods. Our convenient, processed, packaged, artificial American diet is alive and well out in these remote villages. (Uggghhhh!!!!) And people can use food stamps on pop. I am not opposed to food stamps and helping out my neighbor, but if I were to advocate for policy changes, it would be to ban certain “foods” (with zero nutritional value) to be able to be purchased with our tax dollars. Because then our tax dollars then go on to pay for diabetes, obesity and all the complications that result.
Price list (prices vary widely depending on wholesale prices/demand…etc), so it is posted each month. Tons and tons of cigarettes are sold, unfortunately. It seems like 100% of people smoked, or have smoked in the past.
While I was there, several customers came into the store: one man bought a large bag of potato chips, a 12-pack of coke, strawberry wafers and whipped cream. A few others were younger customers who bought candy. They sell lots of cigarettes and lots of pop.
Native food is so much better–there is a cool binder on the nutritional content of native foods in the clinic:
I hope to create a handout with a list of foods that a heart attack patient can eat that is realistic here in Wales. My arrival was advertised on the fridge (“Doctor field visit to Wales”! :))
The only 2 veggies in the fridge: cabbage and carrots.
Highlight of my trip: Conversations with the janitor
The janitor is from a whaling family. He used to be a whaler, until he sustained several injuries. He told me stories of the whale hunts, which he says were “very, very scary” An injured whale is a wild, unpredictable beast that can turn on the small whaling boats at any minute. Now he tells me, most whalers use aluminum skiffs instead of walrus skin umiaqs, large guns and harpoons with bombs that detonate inside the whale instead of harpoons (both penetrate 5-6 feet into the body of the whale with a good shot), and sometimes a tractor to pull the whale up on the beach instead of the people in the village. In his opinion, all of these hunting methods are equally good and accurate, but the modern equipment is less work to make and maintain.
The biggest whale he helped hunt was a bowhead whale, measuring in at 47ft 9.5 inches. The whale that takes the record around here was ~ 52 feet!!!!
Whale jaw bones
The health aids explained to me that there are certain whaling families in the village, but anyone can become a whaler if they want to. And everyone in the village partakes in the spoils of the whale. I am sure the distribution of whale parts is another political/cultural study. In this modern era even women can go out on the whale hunt (before it was strictly men). They can partake in any activity, from sharpening the knives/preparing equipment to shooting at the whale.
They also hunt walruses, seals, fish and other marine life. They eat crabs, clams, snails, mussels, and other seafoods.
Clams are supposed to be washing up on the beach any day now. They expect their arrival when the wind comes from the Northwest, and the water turns brown. Some how the currents change to churn up the bottom of the sea where the clams live and dumps them on to the beach. They are palm sized to hand sized and there are thousands and thousands of them–up to two-feet piles of them!!!! This marks the approach of Winter, and it also feeds them for days. Daily they talk about it with great anticipation.
My favorite quote of the day, by a warm, generous elderly woman. She told me she was going to gather buckets and buckets of clams, and send them out in boxes to other villages/towns. I asked her if she sells them, and she replied “I don’t sell what God gives me.” Rather, she is sending them to her family and friends. I thought it is such a beautiful way to live. If only all of us lived more like that—more giving, more open-handed, less holding on to what was given to us.